Schwannomas are the second most common type of intra-dural lesions involving the thoracic spine. They are frequently seen as solid and heterogeneous lesions. Totally cystic thoracic schwannomas represent a rare pathological schwannoma variant, with only four cases reported in the English literature to our knowledge.
We report an 80-year-old male who presented with upper back pain for 3 months. Magnetic resonance imaging (MRI) showed a cystic lesion at the level of T6–T7 with peripheral contrast enhancement. The lesion was removed in total surgically with complete resolution of the patient’s symptoms.
The diagnosis of cystic schwannomas is often delayed due to the paucity of symptoms and the lack of meticulous investigation. The presence of rim enhancement on contrast-enhanced MRI may be the only clue for the diagnosis. It is important to consider cystic schwannomas in the differential diagnosis of cystic spinal lesions since the best surgical outcome is strongly related to earlier diagnosis and total resection of the lesion.
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Samman, A.M., Bardeesi, A.M. & Alzahrani, M.T. Thoracic cystic schwannoma: case report and review of literature. Spinal Cord Ser Cases 7, 7 (2021). https://doi.org/10.1038/s41394-020-00376-0